Evaluation of the prognostic value of derived neutrophil/lymphocyte ratio in early stage non-small cell lung cancer patients treated with stereotactic ablative radiotherapy

The derived neutrophil-lymphocyte ration (dNLR) is a systemic inflammatory marker. The present study focusing on the prognostic value of pre-treatment dNLR in patients of early stage non-small cell lung cancer (NSCLC). From 2012 to 2016, patients with newly diagnosed early stage NSCLC were investigated. Only these who treated with stereotactic ablative radiotherapy (SABR) were enrolled in this study. dNLR was calculated from complete blood count prior to SABR. The optimal cut-off value of dNLR was determined by receiver operating curve. Kaplan–Meier curves and Cox proportional models were used to analyze the impact of pre-treatment dNLR on disease free survival (DFS) and overall survival (OS). There were 69 patients eligible for analysis, the median follow-up period was 30.9 months. Calculated by receiver operating characteristic curves, the optimal cut off value of dNLR was 1.99. Kaplan–Meier curves demonstrated that a decreased dNLR was correlated with favorable DFS and OS. In univariate analysis, high dNLR was associated with decreased survival; moreover, multivariate analysis revealed that a decreased dNLR was an independent significant favorable prognostic factor for both DFS and OS. An elevated pre-treatment dNLR may be an independent prognostic biomarker for DFS and OS in patients with early stage NSCLC that are eligible for SABR. dNLR is a reliable, inexpensive, simple, and readily available tool for risk-stratification and should be considered in daily clinical practice.